Showing papers by "Ronald Klein published in 1984"

The Wisconsin Epidemiologic Study of Diabetic Retinopathy: II. Prevalence and Risk of Diabetic Retinopathy When Age at Diagnosis Is Less Than 30 Years

Abstract: In a population-based study in southern Wisconsin, 996 insulin-taking, younger-onset diabetic persons were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 17% to 97.5% in persons with diabetes for less than five years and 15 or more years, respectively. Proliferative retinopathy varied from 1.2% to 67% in persons with diabetes for less than ten years and 35 or more years, respectively. For persons with diabetes of 10 years' duration or less, the Cox regression model relates the severity or retinopathy to longer duration, older age at examination, and higher levels of glycosylated hemoglobin. After ten years of diabetes, severity of retinopathy was related to longer duration, high levels of glycosylated hemoglobin, presence of proteinuria, higher diastolic BP, and male sex.

The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years.

Abstract: • In a population-based study in southern Wisconsin, 1,370 patients given diagnoses of diabetes at age 30 years or older were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 28.8% in persons who had diabetes for less than five years to 77.8% in persons who had diabetes for 15 or more years. The rate of proliferative diabetic retinopathy varied from 2.0% in persons who had diabetes for less than five years to 15.5% in persons who had diabetes for 15 or more years. By using the Cox regression model, the severity of retinopathy was found to be related to longer duration of diabetes, younger age at diagnosis, higher glycosylated hemoglobin levels, higher systolic BP, use of insulin, presence of proteinuria, and small body mass.

Prevalence of diabetes mellitus in southern wisconsin

Abstract: The prevalence of known cases of diabetes was ascertained from patient records in an 11-county area in Wisconsin in July 1979 to June 1980. The prevalence in the noninstitutionalized population was found to be 1%. Prevalence rates rose from 0.5 cases per 1000 population in the first decade of life to 44.7 cases per 1000 population in the eighth decade. The highest rates were found in the nursing home population. Males had higher age-adjusted rates than females. No difference in prevalence was found between persons living in metropolitan or nonmetropolitan counties. Determination of prevalence by these methods is a rapid and inexpensive means of ascertainment of known cases of diabetes.

Ophthalmologic Care for Persons With Diabetes

Abstract: The provision of ophthalmologic care to diabetic patients was examined in a large, geographically defined population-based study in southern Wisconsin Of the total of 2,272 patients examined, 902 were taking insulin and were diagnosed before 30 years of age (younger onset) and 1,370 were diagnosed at or after 30 years of age (older onset) Approximately 26% of the younger-onset and 36% of the older-onset diabetic population had never had an ophthalmologic examination Characteristics of the younger-onset and older-onset population associated with never having had an ophthalmologic examination included living in a nonmetropolitan county, being older at the time of diagnosis, having a shorter duration of diabetes, having fewer years of education, receiving their diabetes care from a family or general practitioner, and having better visual acuity Eleven percent of younger- and 7% of older-onset persons with Diabetic Retinopathy Study high-risk characteristics for severe visual loss had never been seen or were seen more than two years before the time of the study Because severe visual loss caused by proliferative diabetic retinopathy may be reduced by timely photocoagulation treatment, this study suggests that a large number of patients who would benefit from ophthalmologic care are currently not receiving it ( JAMA 1984;251:2534-2537)

Blood pressure in a population of diabetic persons diagnosed after 30 years of age.

Abstract: Blood pressure levels were investigated in a population of diabetic persons who were diagnosed at 30 years of age or older and who received their primary medical care in an 11-county area in Southern Wisconsin. Prevalence of hypertension in these 5,104 persons was compared with prevalence figures from the Health and Nutrition Examination Survey (HANES) population. Diabetic women had a higher prevalence of hypertension until 65 years of age than did women of similar ages in the HANES. The diabetic males had a prevalence of hypertension similar to that of male HANES participants. Mean systolic blood pressures tended to be slightly higher in persons with "poorest" level of glucose control compared to those whose blood glucose was "best" controlled. Persons for whom diuretic agents had been prescribed were as likely to have blood glucose values in the "poorest" levels of control as persons not using diuretics.

Gravidity and diabetic retinopathy

Abstract: The relationship between gravidity and severity of diabetic retinopathy was investigated in a population-based sample of diabetic patients. All of these women had had diabetes diagnosed before 30 years of age and were taking insulin. All received their primary medical care in an 11-county region of southwestern Wisconsin (Health Service Area 1). Each participant had an ophthalmologic examination which included stereoscopic fundus photography of seven standard fields in each eye. Photos were graded according to a standard protocol. Of the 397 women, 197 had never been pregnant, 88 had been pregnant once, 56 had been pregnant twice, and 56 had been pregnant three or more times after diabetes was diagnosed. The number of pregnancies was positively associated with the severity of retinopathy. However, after controlling for duration of diabetes, this relationship was no longer apparent. Using an ordinal regression model, duration of diabetes, diastolic blood pressure and glycosylated hemoglobin were significant predictors of the severity of diabetic retinopathy.